Nice and warm weather. How do you know if you are drinking enough water. But how do you ensure that you get enough fluid? Does beer also count? And coffee? And why do we often drink too little?
Young, healthy people do not dry out so quickly, even if it is very hot. As soon as the body loses a lot of fluid, an imaginary bell starts to ring in the brain, causing a feeling of thirst for drinking. In older people, from about 65 years of age, that system is always working less well. Certainly above 80 it will be less. Then it can happen that someone forgets to drink. Anyone who swallows medicines that affect the fluid balance (such as water pills) and, for example, a stomach flu gets, runs a great risk of dehydration. Soft drinks, up to 7 cubes of sugar. Healthy drinks instead of water.
With a starting shortage, the body will lose the moisture present as little as possible. The perspiration is therefore at a low level. That is unhealthy, because sweating ensures that the body temperature does not increase with heat. The kidneys will also produce less urine. Little need to go to the bathroom (less than once every three to five hours) is also a first sign of dehydration. Then fluid flows from the cells to the bloodstream, so that the amount of blood and blood pressure remain. As a result, the cells dry out slowly. That can be noticed by the skin; if it stays upright when it is pulled up for a moment, it can also be a sign of dehydration.
The brain cells are also sensitive to dehydration. This is expressed in confusion. When no moisture enters this stage, dehydration is really harmful. The sodium balance gets disturbed and the blood pressure drops. This gives a light feeling in the head and can lead to fainting. If the moisture and sodium content is not replenished, a shock and a coma may result. So drinking is so important.
In the heatwave in 2010 (five days in a row warmer than 25 ºC, of which three at least 30 ºC) about 500 elderly people died more than normal in such a period, according to figures from Statistics Netherlands. Dehydration is not the main reason for those extra deaths. Usually people with heart or lung problems. Dehydration in the first instance causes all sorts of health problems that can lead to hospitalization. For example, it increases the chance of infections and kidney stones. Too little moisture can also cause thrombosis. American research shows that 7 percent of all over-65s admitted to the hospital have a fluid deficiency.
It is less easy to determine in the elderly. For example, the simple test with the pulling up of the skin does not work; an older skin is usually drier and always remains 'standing'. A symptom such as confusion is not always recognizable, especially when someone is suffering from dementia. And less sweating? Older people do that anyway. There are other ways to check if someone drinks enough, but they are time-consuming and sometimes simply not feasible. Weighing for example. This makes it possible to calculate how much fluid someone receives and loses. But this is very drastic, especially for bedridden people.
'Just' ensuring that a dependent older person drinks enough is also easier said than done. Sometimes the swallow reflex is no longer OK. In nursing homes too, there is not always enough staff to help a large proportion of the residents drink at least two liters per day. Add to this that informal carers are also absent during the summer due to holidays, and the problem is clear.
Lose weight by drinking water. With simple tricks. Do not just put water, tea, coffee or fruit juice, for example, but take a glass yourself, sit down and have a drink together. Pour another time when the glass is empty. Or both eat a water ice cream. A bowl of juicy fruit is also a great way to get extra moisture. If you go on holiday yourself, make sure that someone else keeps an eye on things and takes the time to have a drink together. If you are a caregiver for a dependent older person living independently, please contact the GP to ask if any medication needs to be adjusted to the warm weather. People keep an eye on people who live in a nursing or care home.